Predictors of Norwegian adolescents' sunbathing and use of sunscreen.

A nationwide random sample of 15,169 Norwegian high school students completed a questionnaire about tanning habits, physical self-concept, attitudes, beliefs, and values. Although 90% of the adolescents did use sunscreen, less than 25% used an adequate sun-protection factor, and only 50% applied the sunscreen an adequate number of times when sunbathing. Multiple regression analyses identified these predictors of sunbathing: opportunity to sunbathe, tender skin, heavy smoking, playing down the risk for skin cancer, valuing physical appearance, friends' use of sunscreen (girls only), a positive attitude toward having a tan, favorable physical self-concept, friends' use of sunbeds, and friends' sunbathing. Sunscreen use was also predicted by opportunity to sunbathe and skin type. Furthermore, the effects of perceived risk for skin cancer and peers' use of sunscreen were particularly strong. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward health risks and sunbathing behavior

Sunbathing confers the benefits of looking and feeling good but presents the long-term risk of skin cancer. In a disguised experiment exploring attitudes toward sunbathing by British adults, participants were asked to rate their willingness to take a hypothetical new drug (with different levels of risk) that would make them look and feel good. One aspect of the resulting risk profiles was significantly related to a positive attitude to open-air sunbathing but not to sunbed use, possibly because it was erroneously thought that using a sunbed is not risky. The well-established finding that women are more cautious was confirmed; the risk function for men was curvilinear, in contrast to women, who were willing to increase their risk linearly over their lifetime.     

A psychosocial model of sun protection and sunbathing in young women: The impact of health beliefs, attitudes, norms, and self-efficacy for sun protection.

A psychosocial model of sun protection and sunbathing as distinct behaviors was developed on 202 young Caucasian women and replicated in an independent sample (n?=?207). Proximal outcomes were intention to sun protect and intention to sunbathe; distal outcomes included sun protection and sunbathing behavior measured 5 months later. Objective risk for skin cancer plus 4 classes of psychosocial variables (sun-protective health beliefs, self-efficacy for sun protection, attitudes toward sunbathing, and norms for sunbathing and sun protection) served as predictors. Sun-protective norms and self-efficacy for sun protection predicted only intention to sun protect; sunbathing norms predicted only intention to sunbathe. Susceptibility and advantages of tanning predicted both intention constructs, which, in turn, predicted behavior. These findings distinguish sun protection from sunbathing and provide a basis for intervention design. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alveolar soft-part sarcoma with unusual mitochondrial findings: a case report

In 1996 a randomized sample of 4,020 Swedish adolescents from three birth cohorts were sent a questionnaire consisting of 50 items concerning habitual sun-related behaviours and attitudes, knowledge about melanoma, risk perception and self-image. A total of 2,615 questionnaires were returned. Girls sunbathed and used sunbeds more than boys at all ages. Sunbathing and sunbed use increased with age. Boys who were most satisfied and girls least satisfied with themselves sunbathed most. Those who were least satisfied with themselves used sunbeds most frequently. Girls reported a higher perceived susceptibility to melanoma than did boys. The perception of susceptibility increased with age. Those who were least satisfied with themselves reported feeling most susceptible. The overall main reason for sunbathing was appearance, both for own sunbathing, and to an even higher degree, as a supposed reason for other adolescents' behaviour, and was reported most frequently by girls and the older age groups. The second most 'important' reason for sunbathing was 'feeling warm and comfortable'. Preventive programmes aimed at a change of sun related behaviours among Swedish adolescents have to be tailored to the climate and cultural conditions and must take into account that having a tan, and the warmth of the sun, are highly valued by most adolescents.     

Report of the Department of Defense, National Cancer Institute, Department of Health and Human Services Office of Women''s Health workshop on the mobile breast care center

The present study examines women's decision making about mammography over a 1-year period, using "decisional balance," a summary of women's positive and negative perceptions about mammography derived from the Transtheoretical Model (TTM). Data were from a survey of women ages 50-74 years who completed both the baseline and 1-year follow-up telephone surveys (n = 1144) for an intervention study to increase the use of mammography screening. A shift toward less favorable perceptions about mammography was related to being a smoker and not having a recent clinical breast examination and Pap test. Change in women's attitudes toward mammography was also related to four dimensions of a woman's information environment. Women who rated the opinions of a physician as somewhat or not important, those who reported that at least one family member or friend discouraged them from having a mammogram, and women who felt they lacked enough people in their social network with whom they could discuss health concerns were less likely to express favorable attitudes about mammography over 1 year. In contrast, women who consistently communicated the value of mammography to others expressed more favorable views of screening over the study period. Interventions designed to promote breast cancer screening must recognize that a woman not only reacts to mammography information provided by significant others in her social network but may proactively reach out to others as an advocate of breast cancer screening, thus reinforcing or changing others' opinions or behavior as well as her own.     

Evaluation of a multicomponent appearance-based sun-protective intervention for young women: Uncovering the mechanisms of program efficacy.

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18-25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examination of cognitive variables relevant to sunbathing

This study examined cognitions relevant to sunbathing decision-making in college-aged subjects. Using Jaccard's (1981) theory of alternative behavior as a guiding model, 263 subjects were recruited from psychology classes and administered questionnaires assessing their sunbathing behavioural tendencies, attitudes toward sunbathing, attitudes toward reasonable behavioral alternatives to sunbathing, and cognitive variables underlying these attitudinal variables. The fits of models predicting sunbathing attitudes and sunbathing behavioural tendencies (evaluated using covariate structural equations modeling techniques; LIS-REL VIII) were good for all models tested. In contrast to previous work, the results of this study support the notion that young people will make their decisions regarding sunbathing based on the behavioral alternatives available to them (i.e., generally the one that they prefer most). Furthermore, the multivariate approach used clearly delineates the specific cognitive beliefs and orientations that might be targeted to change these attitudes. The relevance of these findings to skin cancer prevention interventions is discussed.     

Autofluorescence guided biopsy for the early diagnosis of bladder carcinoma

To assess whether there is increased risk of tuberculous infection in children who traveled to or had a household visitor from a country having a high prevalence of tuberculosis, we conducted a case-control study. Children younger than 6 yr of age who had a tuberculin skin test read at public health clinics in areas of California that have a high prevalence of tuberculosis were enrolled. Of the 953 children who had a skin test read, 72 (7.6%) had a positive reaction. By multiple logistic regression analysis, children who had traveled in the 12 mo before the skin test were 3.9 times more likely to have a positive skin test than were children who had not traveled (95% confidence interval [CI], 1.9 to 7.9). Among children born in the United States, those who had traveled were 4.7 times more likely to have a positive skin test (95% CI, 2.0 to 11.2). Children who had a household visitor from a country having a high prevalence of tuberculosis were 2.4 times more likely to have a positive skin test than were those who did not have a visitor (95% CI, 1.0 to 5.5). These data indicate that travel to a country that has a high prevalence of tuberculosis or having a visitor from such countries increase the risk of tuberculous infection among young children. Physicians and tuberculosis control programs should incorporate questions about travel and visitors into their evaluations, and children with a history of extended travel should have a tuberculin skin test.     

Identity-based motivation and health.

People do not always take action to promote health, engaging instead in unhealthy habits and reporting fatalism about health. One important mechanism underlying these patterns involves identity-based motivation (D. Oyserman, 2007), the process by which content of social identities influences beliefs about in-group goals and strategies. Seven studies show the effect of identity-based motivation on health. Racial-ethnic minority participants view health promotion behaviors as White middle class and unhealthy behaviors as in-group defining (Studies 1 and 2). Priming race-ethnicity (and low socioeconomic status) increases health fatalism and reduces access to health knowledge (Studies 3 and 4). Perceived efficacy of health-promoting activities is undermined when racial-ethnic minority participants who identify unhealthy behavior as in-group defining are asked to consider their similarities to (middle-class) Whites (Studies 5-7). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adjustment of adolescent children of a depressed, arthritic, or normal parent.

Examined the joint effects of having a parent with a psychological or physical disability and stressful life events on the mental health of 3 groups of adolescents: 16 adolescent children of a depressed parent, 16 adolescent children of a parent with rheumatoid arthritis, and 16 adolescent children of parents free from psychological or physical disability. Ss were asked to complete a battery of assessments, including the SCL-90, Rosenberg Self-Esteem Scale, Family Environment Scale, and scales assessing life events and satisfaction with school. It was found that, in contrast to the normal group, Ss with arthritic parents reported lower self-esteem, whereas Ss with depressed parents reported lower self-esteem and more symptomatology. However, the 2 risk groups did not differ in terms of mental health or family and school adjustment. Both negative and positive life events were strongly related to poorer adjustment, but only for Ss with depressed and arthritic parents. There was a significant interaction effect of parental disability (depressed vs normal) and negative life events on symptomatology, with the Ss with depressed parents who experienced few negative life events reporting symptom levels equivalent to that of the normal group. Within-group analyses revealed that a positive familial social climate was related to better adjustment among all 3 groups: satisfactory school involvements were related to better adjustment among the depressed-parent and normal groups. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Providing information about breast cancer via public forums

This study examines whether persons who attended a breast cancer education summit or received written materials (i) exhibited improved knowledge about breast cancer; and (ii) used the information themselves, share it with others, or implemented community education/screening programs. Participants (92 lay persons, 67 health professionals who attended; 44 who did not attend but received written materials) were primarily female, with a mean age of 47. They completed a 10-item knowledge questionnaire on four occasions (pre-conference, immediately post-conference, 9 weeks, 6 months). On the third and fourth occasion, participants also were asked how they had used the information. Paired samples t tests revealed that lay individuals (p < 0.001) and health professionals (p < 0.001) exhibited improved knowledge of breast cancer after attending the conference, used the information in their personal health care, and shared it with others, and some implemented education and screening programs. Of nonattendees, only the health professional group retained knowledge gain over time. A conference can produce increased knowledge about breast cancer and stimulate attendees to use information for themselves and share it with others. For lay persons, conference attendance is superior (p < 0.01) to written materials alone, in achieving long-term gain in knowledge.     

Changing knowledge and attitudes about skin cancer risk factors in adolescents.

Examined knowledge, attitudes, and behaviors related to skin cancer (SC), sun exposure, sunscreen use, and use of tanning booths in 903 female and 800 male adolescents. The effectiveness of a brief, school-based intervention designed to increase teens' knowledge and preventive attitudes about SC was also evaluated. Females, older students, and those with high-risk skin types were most likely to use sunscreen and to take precautions. However, overall level of protection was low. Intentions to take precautions were associated with levels of perceived susceptibility to SC, attitudes about the benefits of sun exposure, skin type, and sex. Beyond intentions, sunscreen use was associated with perceived susceptibility and skin type. The 1-session, school-based intervention significantly increased knowledge of and perceived susceptibility to SC but not behavioral intentions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental disorders and access to medical care in the United States

OBJECTIVE: The authors examined the barriers to receipt of medical services among people reporting mental disorders in a representative sample of U.S. adults. METHOD: The sample was drawn from adults who responded to the 1994 National Health Interview Survey (N=77,183). The authors studied the association between report of a mental disorder and 1) access to health insurance and a primary provider, and 2) actual receipt of medical care. Multivariate techniques were used to model problems with access as a function of mental disorders, controlling for demographic, insurance, and health variables. RESULTS: While people who reported mental disorders showed no difference from those without mental disorders in likelihood of being uninsured or of having a primary care provider, they were twice as likely to report having been denied insurance because of a preexisting condition or having stayed in their job for fear of losing their health benefits. Among respondents with insurance, those who reported mental illness were no less likely to have a primary care provider but were about two times more likely to report having delayed seeking needed medical care because of cost or having been unable to obtain needed medical care. CONCLUSIONS: People who reported mental disorders experienced significant barriers to receipt of medical care. Efforts to measure and improve access to health care for this population may need to go beyond simply providing insurance benefits or access to general medical providers.     

Social support, support groups, and the cancer patient.

Surveys the literature on social support and cancer and reports results from an empirical investigation of the factors that led cancer patients to join social support groups. Questionnaire data from 666 21–89 yr old cancer patients show that although most Ss received high levels of social support following cancer, some experienced isolated instances of rejection or did not receive the type of support they wanted from family, friends, and medical caregivers. This appeared to be 1 impetus for joining cancer support groups, although Ss reporting a lack of social support were not generally more likely to join support groups than were other Ss. The Profile of Mood States suggested that attenders were somewhat less likely to be depressed than were nonattenders. In addition, cancer support group attenders were more likely to be White middle-class females, to report having more problems, and to use social support resources of all kinds than were nonattenders. Implications for outreach to cancer patients are discussed, and it is concluded that while support groups may be beneficial for many cancer patients, current programs tend to be used largely by the same segment of the population that uses traditional mental health services. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood sexually transmitted diseases and child sexual abuse: results of a Canadian survey of three professional groups

The purpose of this national survey was to determine the knowledge and attitudes of Canadian health and social services professionals about the occurrence of sexually transmitted diseases (STDs) in children and its implications for child sexual abuse. A mailed questionnaire was sent to a randomly selected sample of 4,500 nurses, physicians, and youth/social workers across the country. Response rates varied from over 60% of nurses and youth/social workers to only 38% of the physicians. Nurses and youth/social workers were younger than physicians, had a proportionately higher number of females within their groups, and more frequently reported that they had or might have been sexually abused as children. Although there was no statistically significant difference among the groups on the composite knowledge score, physicians scored higher than the other two groups on knowledge about STDs, and youth/social workers had the highest knowledge scores about sexual abuse. Some differences in attitudes among the groups were also noted. Overall, the rates of respondents reporting confidence in their ability to treat children with STDs or child sexual abuse were low (26% and 35% respectively). This paper presents the overall results of the survey, and makes recommendations for strategies to enhance professional expertise in the area.     

A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer.

Objective: To test the effects of emotionally expressive writing in a randomized controlled trial of metastatic breast cancer patients and to determine whether effects of the intervention varied as a function of perceived social support or time since metastatic diagnosis. Design: Women (N = 62) living with Stage IV breast cancer were randomly assigned to write about cancer-related emotions (EMO; n = 31) or the facts of their diagnosis and treatment (CTL; n = 31). Participants wrote at home for four 20-min sessions within a 3-week interval. Main Outcome Measures: Depressive symptoms, cancer-related intrusive thoughts, somatic symptoms, and sleep quality at 3 months postintervention. Results: No significant main effects of experimental condition were observed. A significant condition × social support interaction emerged on intrusive thoughts; EMO writing was associated with reduced intrusive thoughts for women reporting low emotional support (η2 = .15). Significant condition × time since metastatic diagnosis interactions were also observed for somatic symptoms and sleep disturbances. Relative to CTL, EMO participants who were more recently diagnosed had fewer somatic symptoms (η2 = .10), whereas EMO participants with longer diagnosis duration exhibited increases in sleep disturbances (η2 = .09). Conclusion: Although there was no main effect of expressive writing on health among the current metastatic breast cancer sample, expressive writing may be beneficial for a subset of metastatic patients (including women with low levels of emotional support or who have been recently diagnosed) and contraindicated for others (i.e., those who have been living with the diagnosis for years). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescents' knowledge of medical terminology and family health history.

Compared 309 youths (aged 10.4–15.7 yrs) and their parents with respect to comprehension of terms for 7 common medical disorders: heart attack, stroke, atherosclerosis, ulcer, hypertension, diabetes, and cancer. For two-thirds of the adolescents, accuracy of reporting of these disorders among the parents and grandparents was assessed. Results indicate considerable variation among disorders with respect to both comprehension of terms and accuracy of family health history. Adolescents' age was a major predictor of knowledge of medical terms. Age was not related to accuracy of family health information. Adolescents' level of accuracy regarding family health history was generally similar to that of previous adult samples, suggesting that family health information is acquired and retained at an early age. Adolescents were more accurate concerning parents' compared with grandparents' history of hypertension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moderators of the Relationship Between Long Work Hours and Health.

The authors examined how associations between work hours and self-reported health are moderated by the reasons given for working overtime, by schedule autonomy, and by the degree of social support experienced, in a survey of 372 train drivers. Respondents who lacked both schedule autonomy and social support demonstrated positive associations between the number of hours worked per week and frequency of physical health symptoms. Conversely, negative associations were observed among respondents reporting low schedule autonomy together with high social support. There were no such interactions in the analyses of fatigue and psychological health outcomes. The findings are discussed in terms of the fit between an individual's actual and desired work hours. The problems of identifying appropriate limits for work hours are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fine-needle aspiration cytology of metastatic small cell carcinoma of the colon: a report of three cases

In an effort to understand the effect of cancer diagnosis and treatment in children and adolescents, and to identify issues that should be addressed with newly diagnosed patients, 85 patients with Ewing's sarcoma family tumors (ESFT) were interviewed about their experience of having cancer. This represents 90% of all eligible patients who survived at least 3 years since their diagnosis and who were treated for ESFT at the National Cancer Institute (NCI) from 1965-1993. The mean age of patients at the time of diagnosis was 15.8 +/- 5.3 years, and mean time since diagnosis was 13.6 +/- 6.4 years. Patients from this cohort had a disease usually related to poor outcome. Patients answered five open-ended written questions. Negative experiences that they described included transient and permanent discomfort and disabilities related to cancer; disruption of life or relationships; and emotional aspects of cancer diagnosis or treatment. Positive aspects of having cancer included changed attitudes about self and life, improved relationships with others, or better job performance. Advice for newly diagnosed patients most often dealt with the emotional aspects of cancer. The importance of patient-to-patient support was frequently described. Overall, having cancer was not an entirely negative experience, and it may result in introspection and improved relationships with others.     

Breast cancer screening adherence: does church attendance matter?

Little is known about the health behaviors of church attendees. This article reviewed telephone interview data of 1,517 women who were church members from 45 churches located in Los Angeles County to determine their breast cancer screening status and to identify the key predictors of screening. Almost all of this sample (96%) reported attending church at least once a month. Key predictors of screening included physician-patient communication, ethnic background, and having medical insurance. Although church-related predictors were not significantly related to screening adherence, the authors compared community-based screening rates from another sample to their sample rates and found that, when controlling for income and education, church members fared better on mammography screening than women who were community residents. This finding suggests that frequent church attendance contributes to better mammography screening status and that the relationship between religious involvement and health behaviors needs further explanation.